妊娠期高血压产妇N端脑钠肽前体、可溶性晚期糖基化终末产物受体的变化及其与心功能的关系

Changes of N-terminal pro-brain natriuretic peptide and soluble receptor for advanced glycation endproducts in puerperas with pregnancy-induced hypertension and their correlations with cardiac function

  • 摘要: 目的 探讨妊娠期高血压患者N端脑钠肽前体(NT-proBNP)、可溶性晚期糖基化终末产物受体(sRAGE)的变化及其与心功能的关系。 方法 选取120例妊娠期高血压产妇作为观察组。另选取正常产妇60例作为对照组。观察组又分为妊娠期高血压组(n=82)和子痫前期组(n=38)。比较3组孕晚期及产前1 d的NT-proBNP、sRAGE水平。比较3组心脏超声指标[二尖瓣血流舒张早期速度峰值与舒张晚期血流速度峰比值(E/A)、二尖瓣血流舒张早期速度峰值与二尖瓣环根部运动速度峰值比值(E/Ea)、收缩期左心室侧壁心肌运动峰值速度(Sm)、左心室整体扭转角度峰值(Ptw)、左心室舒张末期内径(LVDd)、左心房直径(LAD)、收缩期左心室后壁厚度(LVPWd)、室间隔后壁厚度(IVSd)、左心室射血分数(LVEF)], 分析NT-proBNP、sRAGE水平与心脏超声指标的相关性。 结果 子痫前期组孕晚期及产前1 d的NT-proBNP、sRAGE水平显著高于妊娠期高血压组和对照组(P<0.05), 妊娠期高血压组孕晚期及产前1 d的NT-proBNP、sRAGE水平显著高于对照组(P<0.05)。子痫前期组E/A、Sm显著低于妊娠期高血压组和对照组(P<0.05), E/Ea、Ptw显著高于妊娠期高血压组和对照组(P<0.05); 妊娠期高血压组E/A、Sm显著低于对照组(P<0.05), E/Ea、Ptw显著高于对照组(P<0.05)。NT-proBNP与E/Ea、Ptw呈显著正相关(P<0.05)。sRAGE与E/Ea、Ptw呈显著正相关(P<0.05), 与Sm呈显著负相关(P<0.05)。 结论 妊娠期高血压疾病产妇NT-proBNP、sRAGE水平升高,且NT-proBNP、sRAGE升高幅度与妊娠期高血压严重程度和心功能异常有关。

     

    Abstract: Objective To investigate the changes of N-terminal pro-brain natriuretic peptide(NT-proBNP)and soluble receptor for advanced glycation endproducts(sRAGE)in puerperas with pregnancy-induced hypertension and their correlations with cardiac function. Methods Totally 120 pregnant women with pregnancy-induced hypertension were selected as observation group, and 60 healthy pregnant women were selected as control group. The cases in the observation group were further divided into gestational hypertension group(n=82)and preeclampsia group(n=38). The levels of NT-proBNP and sRAGE at time points of the third trimester and one day before delivery were compared among three groups. cardiac ultrasaund indexes such as ratio of early diastolic peak velocity to late diastolic peak velocity(E/A), ratio of early diastolic peak velocity to peak velocity of mitral annulus root(E/Ea), systolic peak velocity of left ventricular sidewall(Sm), peak left ventricular global torsion angle(Ptw), left ventricular end diastolic diameter(LVDd), left atrial diameter(LAD), - systolic left ventricular posterior wall thickness(LVPWd), posterior wall thickness of intraventricular septum(IVSD)and left ventricular ejection fraction(LVEF)were compared among three groups, and the correlations between NT-proBNP, sRAGE and cardiac ultrasaund indexes were analyzed. Results The levels of NT-proBNP and sRAGE in the preeclampsia group were significantly higher than those in the gestational hypertension group and the control group(P<0.05), and the levels of NT-proBNP and sRAGE in the gestational hypertension group were significantly higher than those in the control group(P<0.05). E/A and Sm in preeclampsia group were significantly lower than those in gestational hypertension group and control group(P<0.05), while E/Ea and Ptw were significantly higher than those in gestational hypertension group and control group(P<0.05). E/A and Sm in gestational hypertension group were significantly lower than those in control group(P<0.05), while E/Ea and Ptw were significantly higher than those in control group(P<0.05). NT-proBNP was positively correlated with E/Ea and Ptw(P<0.05), while sRAGE was positively correlated with E/Ea and Ptw(P<0.05), and negatively correlated with Sm(P<0.05). Conclusion The levels of NT-proBNP and sRAGE are increased in pregnant women with pregnancy-induced hypertension, and the increasing ranges of NT-proBNP and sRAGE are related to the severity of gestational hypertension and cardiac dysfunction.

     

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